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Ancient Indian medicine

THE LEGACY OF CARAKA: M.S.Valiathan; Orient Longman Pvt. Ltd., 160, Anna Salai, Chennai - 600002. Rs. 550.

MEDICAL LITERATURE of ancient India has been systematised periodically into works of singular excellence. One such work is the Caraka Samhita (a revised version of Agnivesa's earlier work), named after its author, the master physician Caraka, whose time and place are a matter of debate.

His Samhita, a compendium of systematically arranged text and verse, is an intellectual watershed containing the collective knowledge of medicine existing down the ages from the Vedic to the post-Vedic eras. It contains the stream of Ayurvedic knowledge coming from divine origins, as tradition would have it, first propounded by Brahma and then passed on through Dakshaprajapati, the Asvins, Indra, Bharadwaja and Atreya Punarvasu to Agnivesa.

And as Ayurveda is considered an "Upa Veda" or a derivative of the Vedas, it rests heavily on the sophisticated medical contents of the Atharva Veda and the associated Garbhopanishad (the Upanishad related to human intra-uterine gestation) along with less esoteric but equally valuable inputs from folk medicine.

In keeping with Indian tradition, wherein all science is moored in philosophy and related metaphysics, Caraka draws on the Sankhya, Vaisesika and the Nyaya schools of philosophy to define terminology and concepts, to explain and elaborate the philosophy behind the principles and practice of internal medicine.

In concordance with other Ayurvedic texts (such as Susruta Samhita and Astanga Hridaya), the Caraka Samhita has 120 chapters arranged in eight Sthanas or sections: Sutra, Nidana, Vimana, Sarira, Indriya, Cikitsa, Kalpa and Siddhi. While each section deals with an independent topic, some repetition, overflow and splitting of topics in various sections does exist. This of course, is inevitable given the number of redacted versions and the consequent deletions and interpolations that any ancient work will suffer.

The purpose of the work very clearly was two-fold. The first was to teach and train medical students in anatomy, physiology, pharmacology and clinical medicine supported by a grounding in medical ethics. The second was to serve as a compendium of continuing medical education programmes with consensus statements evolved at medical conferences by a sifting of evidence through a process of peer review.

Caraka Samhita therefore is contemporary in terms of concepts of medical training and practice. It is no wonder then that the book has remained a beacon to medical practitioners down the ages. The author is one such individual, who though a modern cardiac surgeon and eminent medical administrator and academician, has been attracted intellectually to this ancient text.

The author has chosen to present the translation of the book in a format that is uniquely his own within the 600 odd pages of a well-produced hardbound book, of reasonable price. Rather than supply verse and translation in the traditional manner, he has penned the gist of the Sthanas drawn from the elegant and authoritative commentary on Caraka Samhita, namely, the Ayurveda Dipika of Cakrapani Datta.

The book commences with an introduction, aimed predominantly at those unfamiliar with Ayurveda, introducing simply but comprehensively, the basic tenets of the system. Thereafter, the author has taken the liberty of rearranging the material from the Sthanas topically, with meticulous referencing to the original verses and text.

For instance, rather than start with the first or Dirganjivitiya section of the Sutra Sthanam, he has clubbed the matter on the equilibrium of Dhatus, Dosas and drug formulations drawn from the Sutra, Sarira and Vimana Sthanams. His approach, though unorthodox, serves to keep the threads of thought intact for the reader.

Each section begins with a photograph of sculptures of the Kusana period (presumably, the time of Caraka) and carries black and white line drawings illustrating the text. There is a very definite sense of authenticity to these and the credit for this is given by the author to the artist Abraham Joy. The meticulous editorial effort that has gone into the book merits special mention, given the exacting demands of transliteration and diacritisisation of the Sanskrit terms.

With the discipline of a modern medical scientist, the author has appended a list of botanical names for the herbs mentioned, along with a glossary and an index. What is particularly impressive in his approach is that while adopting a contemporary style of interpretation, there are no forced comparisons to allopathy, a pitfall many modern writers fall into, under the false assumption that the final test of validity for any system of medicine is conformity with allopathy.

The author has instead, merely brought out the harmony of the thinking behind the diverse systems while respecting the right of a system to self-validation. All this goes into making the book an intellectually refreshing read.

UMA KRISHNASWAMY

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